Safer opioid supply and health outcomes

In the Article by Tara Gomes and colleagues,¹ it was concluded that initiation of safer opioid supply (SOS) programmes was associated with improvements in the rate of opioid toxicities, all-cause emergency department visits, all-cause inpatient hospitalisations, incident infections, and non-primary care-related health-care costs. The benefits in these factors were attributed to the initiation of SOS, similar to what was seen in the matched methadone initiation cohort, with the exception that the SOS group had significantly higher rates of opioid toxicity. There are several concerns that were not discussed by the authors, including methadone initiation literature, clarity of how much methadone or other opioid agonist treatments (OATs) were received, the frequency and extent of social services provided, and health-care use, which might affect the conclusions suggested.